Assessment of Myocardial Function in Children before and after Autologous Peripheral Blood Stem Cell Transplantation

Abstract

TDI detected subtle abnormalities in systolic and diastolic functions before and after HSCT, which suggests that a conditioning regimen may affect cardiac function.

Assessment of Myocardial Function in Children before and after Autologous Peripheral Blood Stem Cell Transplantation

“…In a pediatric cohort suffering from atrial tachycardia, Ge et al 2 found that left ventricular (LV) function assessed with the TDI parameter Sm advances an early detection of LV dysfunction. In agreement to ElMarsafawy et al, 1 Klitsie et al 3 found that TDI parameters were able to detect subclinical impairment of systolic biventricular function in children with congenital heart defects. ElMarsafawy et al 1 investigated children with an age range of 3-14 years and found that both, the Sm and the S 0 values, were significantly reduced in patients undergoing HSCT compared to the control group.…”

“…With great interest, we have read the article, "Assessment of Myocardial Function in Children before and after Autologous Peripheral Blood Stem Cell Transplantation" from ElMarsafawy et al 1 They performed a prospective casecontrol study of 19 children (compared with an age-matched control group) who were undergoing a peripheral hematopoietic stem cell harvest and planned high-dose conditioning chemotherapy with autologous peripheral blood stem cell transplantation (HSCT). 1 Before and 3 months after the HSCT, the presence of a possible functional myocardial impairment was investigated with the use of the tissue Doppler imaging (TDI) parameters, peak mitral annular systolic velocity (Sm), and tricuspid annular peak systolic velocity (S 0 ). In a pediatric cohort suffering from atrial tachycardia, Ge et al 2 found that left ventricular (LV) function assessed with the TDI parameter Sm advances an early detection of LV dysfunction.…”

Cardiotoxicity and cardiomyopathy in children and young adult survivors of hematopoietic stem cell transplant

“…Studies of both pediatric and adult patients have shown reductions in cardiac function in a subset of patients soon after HSCT . While short‐term changes to function may not necessarily predict long‐term cardiac outcome, they do demonstrate HSCT to be a cardiotoxic procedure for a subset of patients.…”

“…In children who receive anthracyclines, changes in ventricular wall thickness likely precede overt changes in shortening fraction or ejection fraction . In children, tissue Doppler imaging has been used to identify subtle abnormalities in systolic and diastolic functions 3 months after autologous HSCT; however, it is not known whether these changes persist for long term . Speckle‐tracking echocardiography is a means of tracking movement patterns to determine tissue motion and deformation, which can then be quantified as a measure of strain.…”

“…69,70 In children, tissue Doppler imaging has been used to identify subtle abnormalities in systolic and diastolic functions 3 months after autologous HSCT; however, it is not known whether these changes persist for long term. 43 Speckle-tracking echocardiography is a means of tracking movement patterns to determine tissue motion and deformation, which can then be quantified as a measure of strain. A large systematic review of children and adults undergoing chemotherapy showed that changes in global longitudinal strain predict decreased ejection fraction and heart failure.…”